543910265-3-17-2022-04-CC-JTHN-CCLVSL-20220317164144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543910265
Report Date: 03/17/2022
Date Signed: 03/17/2022 04:41:56 PM

Document Has Been Signed on 03/17/2022 04:41 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	CORREA, CHERILYN FAMILY CHILD CARE		FACILITY NUMBER:	543910265
ADMINISTRATOR:	CORREA, CHERILYN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 280-5184
CITY:	VISALIA	STATE: CA	ZIP CODE:	93291
CAPACITY:	14	CENSUS: 8	DATE:	03/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Savanna Correa - Assistant Child Care Provider		TIME COMPLETED:	05:00 PM

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On 3/17/2022 Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection. LPA was met by the licensee’s assistant child care provider, Savanna Correa. Also present was Staff #1 (S1). Days and hours of operation are Monday through Friday, 7:30AM-5:30PM.

LPA toured the home inside and outside and a census was taken. Licensee’s current facility sketch was reviewed, and Savanna Correa confirmed that the kitchen, dining room, bathroom, bedroom #1, and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob covers. There is no swimming pool or other bodies of water on the premises. Firearms and ammunition are stored and locked separately. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559)280-5184.

LPA discussed the safe sleep regulations with Savanna Correa and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Savanna Correa ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained (see next page, LIC809C).

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CORREA, CHERILYN FAMILY CHILD CARE	FACILITY NUMBER: 543910265
	VISIT DATE: 03/17/2022

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LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Savanna Correa’s Mandated Reporter Training was completed on 6/17/21. Savanna Correa’s pediatric CPR/First Aid expires on 8/2023. A review of records indicates that Savanna Correa has immunization records on file for influenza, pertussis and measles; S1’s file was missing proof of aforesaid immunization records.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Savanna Correa was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) are not currently being provided. Savanna Correa is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Savanna Correa discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency was cited (see next page, LIC809D).

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/17/2022 04:41 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CORREA, CHERILYN FAMILY CHILD CARE	FACILITY NUMBER: 543910265
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review, the licensee did not comply with the section cited above in 1 out 2 staff files reviewed. Licensee was unable to provide proof of influenza, whooping cough, and measles immunization for S1. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/15/2022
	Plan of Correction
1 2 3 4	Savanna Correa stated that she will send proof of immunization, for S1, to Fresno Community Care Licensing office by 4/15/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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